Despite a coalition of Republicans and moderate Democrats in the U.S. Senate working to reopen the federal government after the longest shutdown in history, many Washingtonians are still uneasy about the upcoming cost of medical insurance and the gutting of the Affordable Care Act (ACA), popularly known as Obamacare.
While senators voted 60-40 on a federal funding agreement, the political deal comes with concerns of rising health care premiums and the expectation that the Senate will review the ACA issue in December.
There are District residents such as Mary Blackwell who hope that Democratic senators consider people like her, who are struggling to keep good health coverage on average budgets.
“The Obamacare will allow all Americans to have an affordable health care plan,” Blackwell, 68, told The Informer. “If Trump has his way, insurance will skyrocket, which will cause a vast majority of Americans being uninsured.”
Blackwell, who lives in Southeast D.C., is not the only person concerned.
Open enrollment for health care plans started on Nov. 1, and finance experts say medical plan premiums will rise in price due to inflation and insurance industry pressures as a matter of course. However, if the U.S. Congress does not pass a bill extending the Obamacare tax credits that makes health care premiums cheaper to purchase, experts say millions of low-and-middle income Americans could lose their medical insurance by Jan. 1.
Earlier this year, the U.S. Congress passed and Trump signed a “Big Beautiful Bill” that took millions of dollars out of Medicaid, the national health care program that supports low-income and disabled adults, handled by state level jurisdictions such as the District.
People who are not eligible for Obamacare generally can enroll in Medicaid but the jurisdiction must have adequate funding for the increased enrollment in the program. To that point, Blackwell is apprehensive.
“If the federal government doesn’t fund their part of Medicaid with state funds, poor families who depend on Medicaid will be left with no insurance,” she said. “This will cause the poor not to be able to continue their health care, causing widespread illness and maybe death by being uninsured through Medicaid. With the government being shut down, how are the insurance premiums being paid when federal workers are not receiving a paycheck? This will make them have second thoughts about going to the doctor.”
If Obamacare is cut, those on ACA plans may now have to pay the full rate of insurance, meaning premiums could rise by 25%-30%, according to Johns Hopkins Bloomberg School of Public Health.
D.C. Shadow Rep. Oye Owolewa (D), the plans to reopen the government without addressing the potential exponential rise in health care costs.
“As an elected pharmacist, I’m extremely concerned with the partisan gamemanship the Republican controlled federal government is playing with people’s health care,” Owolewa, a candidate for an at-large seat on the D.C. Council, told The Informer, “This government shutdown proves the need for a Medicare for all style universal health care system. It’s the only pathway forward for improved health care outcomes and decreased costs.”
As politicians in the House and Senate debate about health care premiums, Blackwell declared: “Having health insurance is an American right, and not a privilege.”
Blackwell’s Health Finance Dilemma
Like a number of District residents, Blackwell has to grapple with the ins and outs of balancing health, career, and financing basic needs such as health care, particularly because she is unemployed.
“It’s not that I choose not to be working. It’s just that when I had an injury to my back, it brought me out on an early retirement,” she said. “I was a kindergarten teacher for over 40-some years. But the government really doesn’t take into consideration, I think, how they will meet their needs from day to day.”
While Blackwell told The Informer she makes things work from month to month, it’s been a challenge to pay for health care.
At one time, she was able to utilize a major part of Medicare, the national health insurance program for Americans 65 and older.
But that appears to no longer be the case.
“They basically said I no longer was eligible for Part B of the Medicare program due to the fact my husband makes too much money,” she said. “So by them taking a lump sum between $185 to $200 for my monthly income, it has literally put me in a financial hole, struggling to meet my needs every month.”
D.C. Government Officials Speak About Premiums Increase
The D.C. Department of Insurance, Securities and Banking (DISB) announced that it approved the 2026 health insurance rates for individual and small business plans on Sept. 29. Essentially, the rates reveal an average increase of 8.7% for individual plans and 9.5% for small group plans–with the goal of delivering $1.2 million in savings to residents.
DISB Commissioner Karima Woods said the Bowser administration is committed to keeping health care plans at a reasonable cost.
“Thanks to Mayor Bowser’s leadership, DISB is laser-focused on protecting D.C. consumers from unfair pricing and discriminatory coverage,” said Woods. “We rigorously reviewed 188 health plans this year to ensure they meet the District’s high standards–because every resident deserves access to affordable, equitable and transparent health insurance.”
DISB evaluated rate filings from CareFirst Blue Cross Blue Shield, Kaiser Permanente and UnitedHealthcare. The final approvals to be offered to District residents came after a Sept 11 public hearing where actuaries presented their findings and residents relayed personal stories and issues.
The agency’s final decision also received input from other stakeholders such as nonprofits, consumer advocates and the leadership of the DC Health Benefit Exchange Authority, the District’s ACA arm.
Open enrollment for individuals and families through the DC Health Link runs until Jan. 31.
Purvee Kempf, deputy executive director of the DC Health Benefit Exchange Authority, said many District residents who aren’t enrolled in Medicaid or Medicare and do not have health insurance by way of their employer will face challenges.
“This year will be harder than most,” she told The Informer. “A federal health insurance tax credit that lowers monthly premiums expires on [Dec. 31]. This impacts approximately 4,400 residents who buy their own coverage on DC Health Link. Their health insurance premiums will be much higher. Some will no longer qualify for lower premiums. Others will be eligible for some relief but will have to pay a lot more in 2026.”
Kempf said seven out of 10 people with lower premiums in the District are sole proprietors and small business owners who buy their own insurance. For example, she said a couple– ages 55 and 56 years old who own a small business in the city with an annual income of $88,000— will see their monthly premium increase from $328 a month to $2,295 monthly.
Kempf recommends residents to shop around and look at other plans for better savings.
“Shop for a plan that fits your budget, consider not only premiums, but deductibles, and cost sharing if you use health care services,” she said.
She said planning ahead as far as what health care plan to purchase should be done “sooner than later.”
As far as Blackwell’s Medicaid concerns, Kempf’s agency launched the Healthy DC Plan on Nov. 6, designed to address concerns about those who are set to be dropped off of the Medicaid program. The plan offers health care coverage at no cost to eligible residents and has no monthly premiums, out-of-pocket-costs like deductibles or copayments for covered services.
Services covered include: doctor visits, hospital stays, prescription medications, emergency care, preventive care, laboratory services, and mental health care.
“Healthy DC Plan is a great new coverage option for DC residents,” said Mila Kofman, executive director of DC Health Benefit Exchange Authority. “I want to thank our sister agencies—especially the Department of Health Care Finance, the Department of Insurance, Securities, & Banking, and DC Health—for working hand-in-hand to quickly stand up this program. Thanks also to the three health carriers that agreed to participate and to the diverse members from our community who provided important input throughout plan development.”
Kempf encourages District residents to contact her agency if they need assistance with selecting a health plan or for general information. If there are any changes made by Congress, she said her agency will keep the public informed.
Meanwhile, Blackwell said she will cope with the system the way it is because she wants to live as healthy a lifestyle as possible.
“That’s just the way it is right now,” she said. “I know I shouldn’t decide which medication I should take because all of my medication is probably 100% needed for me to have a comfortable life. But I choose to do that because I want to maintain good health….”
